=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427583830
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANNAH SMITH THERAPY AND WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2017
-----------------------------------------------------
Last Update Date | 11/30/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 E WASHINGTON ST SUITE 1225
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60602-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-355-4730
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 E WASHINGTON ST SUITE 1225
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60602-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HANNAH LAMMERS
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 815-355-4730
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 166-001019
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------